The epidemiology of microbial keratitis with silicone hydrogel contact lenses

Stapleton, Fiona, Keay, Lisa, Edwards, Katie, & Holden, Brien (2013) The epidemiology of microbial keratitis with silicone hydrogel contact lenses. Eye and Contact Lens, 39(1), pp. 78-85.

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It was widely anticipated that after the introduction of silicone hydrogel lenses, the risk of microbial keratitis would be lower than with hydrogel lenses because of the reduction in hypoxic effects on the corneal epithelium. Large-scale epidemiological studies have confirmed that the absolute and relative risk of microbial keratitis is unchanged with overnight use of silicone hydrogel materials. The key findings include the following:

(1) The risk of infection with 30 nights of silicone hydrogel use is equivalent to 6 nights of hydrogel extended wear;

(2) Occasional overnight lens use is associated with a greater risk than daily lens use;

(3) The rate of vision loss due to corneal infection with silicone hydrogel contact lenses is similar to that seen in hydrogel lenses;

(4) The spectrum of causative organisms is similar to that seen in hydrogel lenses, and the material type does not impact the corneal location of presumed microbial keratitis; and

(5) Modifiable risk factors for infection include overnight lens use, the degree of exposure, failing to wash hands before lens handling, and storage case hygiene practice.

The lack of change in the absolute risk of disease would suggest that exposure to large number of pathogenic organisms can overcome any advantages obtained from eliminating the hypoxic effects of contact lenses. Epidemiological studies remain important in the assessment of new materials and modalities. Consideration of an early adopter effect with studies involving new materials and modalities and further investigation of the impact of second-generation silicone hydrogel materials is warranted.

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11 citations in Web of Science®

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ID Code: 67444
Item Type: Journal Article
Refereed: Yes
Additional URLs:
Keywords: epidemiology, microbial keratitis, contact lenses
DOI: 10.1097/ICL.0b013e3182713919
ISSN: 1542-233X
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > OPTOMETRY AND OPHTHALMOLOGY (111300)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Optometry & Vision Science
Deposited On: 17 Feb 2014 23:08
Last Modified: 19 Feb 2014 00:20

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